A persistent feeling of a lump in the throat while lying down is seen in a couple of different situations. It is common to have the feeling for a short amount of time as it could be due to a mild infection in which mucous production is increased and so causes the symptom. However this would resolve with a short course of antibiotics.
GERD: A similar symptom of a lump in the throat, particularly in the supine position (lying down) is seen in a condition known as GERD. Gastroesophageal reflux disease or GERD is associated with other symptoms such as heartburn and regurgitation as well.
Pathology: The basic cause of GERD is a change in the normal barrier function between the stomach and the esophagus. This could be caused by an abnormal esophageal sphincter, scleroderma or even a hiatal hernia. GERD is also associated with overweight and obesity.
Investigations: The diagnosis for this condition is mostly based on clinical signs and examination however other tests such as Esophageal Ph monitoring may be done to confirm the diagnosis.
Treatment: Once the diagnosis has been confirmed, the patients are prescribed a few lifestyle changes as might apply to them as well as a course of medications. The lifestyle changes include a loss of weight, avoiding smoking and alcohol intake, and avoiding any dietary substances that are known to aggravate the symptoms.
In rare cases when none of the above methods show any improvement, surgery may be required to be done to alleviate the problem.
Hiatal hernia: Even though GERD is commonly associated with hiatal hernia, there is also a large number of patients that do not have any of the symptoms associated with GERD. A hernia basically occurs whenever a part of the body pushes into a region where it does not belong. A feeling of a lump in the throat, particularly while lying down could be caused by a hiatal hernia where part of the stomach pushes up into the chest and applies pressure in the region of the neck.
The sliding kind is more common and less dangerous.
The treatment for this is most often symptomatic however if the doctors feel that there is a risk for further complications then a surgical intervention might be necessary. A surgical course of treatment if common for the paraesophageal type of hiatal hernia as there is a risk of stomach strangulation in that case.
Laryngopharyngeal reflux: This is a disease with many of the same symptoms as seen in GERD, however there is no heartburn in this disease and that is one of the main differentiating features.
Tumors: It is standard procedure to rule out the presence of any cancerous growth when an abnormal lump or growth is felt. The doctor may require a biopsy or scans to rule out this possibility.
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